Covid admissions are on the rise again in the state of SP

Hospitalizations for Covid-19 in the state of São Paulo rose again, passing the 1,000 hospitalizations this week. Last Tuesday (28), the state registered 581 new admissions, reaching the mark of 1,015 patients in ICU beds. In ward beds, there are 1,454 inpatients with Covid.

The level of one thousand hospitalizations was surpassed on Friday (24), with 1,020. On the same day, 492 new admissions were registered.

The weekly moving average of new admissions by Covid or suspected cases almost doubled in the last month — it jumped from 283 in the first week of December to 465 in the latter (until Tuesday, 28), according to data from Infotracker, a project by USP and Unifesp that monitors the pandemic.

The variation in the number of hospitalizations in the last seven days was 19%. The upward trend, however, could already be noticed since the second week of December. The period coincides with the flu epidemic caused by the influenza virus that hits the capital and with the community transmission of the omicron variant.

As the government of São Paulo does not discriminate the beds based on the tests that differentiate the viruses, it is not possible to know for sure whether all hospitalizations actually refer to Covid.

The metropolitan region, especially the capital of São Paulo, concentrates the highest number of cases: 604 are hospitalized, or almost 60% of the total 1,015 admissions in ICU beds, and the moving average jumped from 156 to 308 this past week. Only on this Wednesday (29), the city of São Paulo had 219 hospitalized patients. On the 7th, there were 107. The occupancy rate is at 30%.

The data were taken from the Seade platform of the São Paulo State Government, which does not use the federal government’s Sivep-Gripe and e-SUS Notifica platforms, which have been unstable in recent weeks after a hacker attack. As hospital admission data are sent directly by the municipal health secretariats to the State Health Secretariat, they are not subject to delays.

Private hospitals in the capital also record an increase in admissions for Covid-19. At Albert Einstein, the number rose from 15 in the first week of December to 43 in the fourth week (until the 28th). In the ICU-Covid, there was a drop in hospitalized patients, from 57 to 23.

At Hospital Alemão Oswaldo Cruz, the number of Covid-19 cases in inpatient units rose from four cases in early December to 28. Of that total, three are in the ICU.

For Wallace Casaca, coordinator of Infotracker, it is quite possible that a large part of these new hospitalizations registered in the state are due to Covid, if we take into account what is happening in other countries since the arrival of the omicron variant.

“We are growing. The government has suggested that the increase is due to the influenza outbreak. But it is necessary to consider that the rapid tests for Covid, which are being made available, are not as effective in detecting the new omicron variant”, says Casaca.

Another fact that catches the researcher’s attention is the fact that Rio de Janeiro has also faced a flu epidemic, with many cases, but hospitalizations remained stable. “Why is São Paulo having this explosion of cases of hospitalizations for influenza and not in Rio?”.

The same vision is shared by Unesp physicist and member of the Covid-19 BR Observatory Roberto Kraenkel. “There is a very strong rise that cannot be explained only by the flu in early December, and at that time no one was testing for flu. And we know that the micron is coming, just see that it comes from all sides, in Europe, in the United States, why think that it won’t be like that here too?” he says.

The increase in the incidence of hospitalizations for the flu syndrome does not show signs that it will stop anytime soon, assesses physicist Leonardo Souto Ferreira, from Unesp, who is researching the mathematical modeling of epidemics.

“Regardless of the model, the data for new admissions in the last seven days has shown a clear growth since mid-December, and it is less susceptible to delays on weekends. The data for new daily admissions, on the other hand, has reached September levels”, he says. .

When contacted, the State Department of Health said that it maintains monitoring of the epidemiological scenario in all regions, reinforces the drop in indicators of the pandemic and states that it is wrong to attribute the data to Sars-CoV-2 alone, as there are other viruses in circulation , like the flu.

The city of São Paulo has seen a rise in hospitalizations for flu in the previous three weeks, also seen in the explosion of tests for influenza in private and public laboratories. At Fleury, in December 2020, 300 flu tests were carried out, a number that reached 35,000 in the period from December 1st to December 28th of this year.

“But it’s not just the flu. Our Covid tests have doubled this month, reaching the daily record of April this year. Last Tuesday (28), there were 6,600 tests, compared to 3,000 in November and early December,” says the director- Grupo Fleury physician, Celso Granato.

As new tests grow, positivity, that is, the rate of positive results among the tests performed, has exploded. “It was 2% in early December and has reached 20% now. I don’t think this is just for people who want to test themselves preemptively, this for me is the omicron”, he says.

At Hospital Sírio-Libanês, the positivity for Covid in cases of flu-like symptoms that reach the emergency room rose from 3% to 30%.

According to Granato, the new strain is already predominant in the sequenced samples. “Now, it has a differential compared to other variants, which is a very high viral load. Many [dos pacientes] they have already been vaccinated and for that reason they may be milder, but if there is an increase in cases, there will be an increase in hospitalizations as a result,” he says.

According to Miguel Cendoroglo Neto, Einstein’s director-superintendent of medical and hospital services, most patients hospitalized by Covid have not required ICU beds.

Of the ten patients hospitalized with Covid this Tuesday, only one was in the semi-intensive unit. None needed to be intubated. At the height of the pandemic, Einstein had 305 inpatients, with 150 intubated.

According to the latest hospital report, 61% of the samples sequenced are from the micron. Most refer to symptomatic patients, who went through the emergency room.

Einstein, according to Neto, had to resort to additional resources, especially more health professionals, to attend to the large volume of patients with respiratory syndromes. The expectation is that other hospitals take back teams and beds to Covid.

For the specialists, the precautions follow the same: use of masks, preferably of the PFF2 type, distancing, avoiding agglomerations, hand hygiene with soap and water or alcohol -in the case of the flu- and the booster dose of the Covid vaccine .

“It was just relaxing a little that it started to increase again at a time when a new variant appeared, so care needs to be resumed”, says Granato.